Nair Lekha Madhavan, Krishna K M Jagathnath, Kumar Aswin, Mathews Susan, Joseph John, James Francis Vadakkumparambil
Genitourinary Clinic, RCC, Thiruvananthapuram 695011, India.
Department of Epidemiology and Biostatistics, RCC, Thiruvananthapuram 695011, India.
Ecancermedicalscience. 2020 Nov 18;14:1145. doi: 10.3332/ecancer.2020.1145. eCollection 2020.
Germ cell tumour of the testis is the most common cancer in young men in the western world. India has the lowest incidence globally, and hence Indian data are sparse. We report the outcomes of patients with nonseminomatous germ cell tumours of testis treated at a tertiary cancer centre in South India over a period of 10 years. Patients with a histopathological diagnosis of nonseminomatous germ cell tumours of the testis from 1 January 2006 to 31 December 2016 were included in the study. Patient demographics, tumour characteristics and treatment details were retrieved from case records. Kaplan-Meier method was used to estimate progression-free survival (PFS) and overall survival (OS). Cox regression model was used to analyse the prognostic factors. One hundred and nineteen patients with nonseminomatous germ cell tumours of the testis were included in the study. The median follow-up was 81 months. The estimated 4-year OS and progression-free survival were 87.1% and 84.5%, respectively. The four-year OS for good, intermediate and poor-risk groups was 93.6%, 87.5% and 52.6%, respectively. The PFS at 4 years was 91.4%, 87.8% and 47.4% for good, intermediate and poor-risk groups, respectively. The presence of nonpulmonary visceral metastasis and biochemical response after chemotherapy were significant predictors for OS and PFS in multivariate cox proportional hazards regression. The survival figures are comparable to the rest of the world except in the poor prognostic risk group. The inferior survival noticed in this group of patients may be due to the lack of good salvage procedures. High-dose chemotherapy with stem-cell support may be considered more often for this group of patients.
睾丸生殖细胞肿瘤是西方世界年轻男性中最常见的癌症。印度的发病率在全球最低，因此印度的数据较为稀少。我们报告了在印度南部一家三级癌症中心接受治疗的睾丸非精原细胞瘤患者在10年期间的治疗结果。纳入研究的患者为2006年1月1日至2016年12月31日期间经组织病理学诊断为睾丸非精原细胞瘤的患者。从病例记录中检索患者的人口统计学资料、肿瘤特征和治疗细节。采用Kaplan-Meier方法估计无进展生存期（PFS）和总生存期（OS）。使用Cox回归模型分析预后因素。119例睾丸非精原细胞瘤患者纳入研究。中位随访时间为81个月。估计4年总生存率和无进展生存率分别为87.1%和84.5%。低、中、高风险组的4年总生存率分别为93.6%、87.5%和52.6%。低、中、高风险组的4年无进展生存率分别为91.4%、87.8%和47.4%。在多因素Cox比例风险回归中，非肺内脏转移的存在和化疗后的生化反应是总生存期和无进展生存期的重要预测因素。除了预后不良风险组外，生存率数据与世界其他地区相当。该组患者生存率较低可能是由于缺乏良好的挽救治疗方法。对于该组患者，可能更常考虑采用干细胞支持的高剂量化疗。
